Which symptom is most commonly associated with hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is characterized by the abnormal thickening of the heart muscle, which can lead to several clinical manifestations. One of the most commonly reported symptoms in patients with HCM is dyspnea, or difficulty breathing. This symptom arises primarily due to the diastolic dysfunction caused by the thickened ventricular walls, which impede normal filling of the heart. As a result, patients often experience increased pressure in the lungs, leading to shortness of breath, especially during exertion or physical activity.

While chest pain, syncope, and arrhythmias can also be associated with hypertrophic cardiomyopathy, they are less frequently encountered as the primary symptom when compared to dyspnea. Chest pain might occur due to ischemic episodes, and syncope can result from dynamic left ventricular outflow obstruction or arrhythmias, but dyspnea is typically the most prevalent complaint, making it the most representative symptom of the condition. Understanding the pathophysiology of HCM provides insight into why dyspnea is commonly observed, reinforcing the importance of recognizing this symptom in clinical practice.